Six postmenopausal women (ages 50 to 65 years) developed palmar fasciitis and polyarthritis associated with a malignant ovarian tumor. Rheumatic signs preceded the diagnosis of adenocarcinoma of the ovary by 5 to 25 months. All had bilateral pain and limitation of motion of the shoulders and hands as well as prominent palmar fasciitis and polyarthritis. Arthritis of the elbows, wrists, knees, ankles, and feet was also common. Two patients had carpal tunnel syndrome. Nonresectable tumor with ascites and peritoneal metastatic seeding was found in all patients. Endometrioid carcinoma, poor tumor differentiation, and unusually severe stromal proliferation of fibrous tissue were seen. There was no consistent improvement of the musculoskeletal syndrome after corticosteroid treatment or chemotherapy. All patients died 2 to 17 months after diagnosis of the neoplasm.